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Pumped for a baby in NICU, nursing, and oversupply

My son was born at 36 weeks and spent two weeks in NICU. During that time I pumped for him and in the course of two weeks developed an oversupply (pumping seven times a day, I've been making over 40 ounces every 24 hours-I actually had to start storing his milk at home). Once they got him up to full feeds four days ago I was allowed to nurse him, so I've been nursing him for two feedings and he's been doing great and we were cleared to switch to exclusive nursing upon discharge today without supplements. Now, my only problem is weaning my supply down to match his demand. I want to do it gradually so I won't be in pain and also so I won't harm my supply. To that end I'm planning on no bottles for the next two to three weeks and only pumping for five to ten minutes after a feed as needed so I avoid engorgement. Any other tips? I'm not new to pumping (I EP'ed for my daughter for a year and made a ton of milk) but syncing up my supply to my son's demand is foreign territory for me.

Re: Pumped for a baby in NICU, nursing, and oversupply

I think you're right to want to go slowly when it comes to reducing supply down to a level that more accurately meets your baby's needs. My suggestion would be to focus on how you feel, rather than on pumping for a certain time increment right after nursing. Let's say you nurse and you feel pretty okay- how about waiting a while before picking up the pump? As long as you're not uncomfortably full, you don't really need to pump (barring the development of a plugged duct or mastitis). And if you do get uncomfortable, then you either offer the breast to the baby or you pump- or, preferably, hand express- enough milk to restore comfort. And once you're comfortable, you just wait for baby to be ready to nurse again.

Have you seen a LC or IBCLC about the plan to supplement? A lot of 36-37 week babies nurse just fine, and no supplements are needed. A LC/IBCLC might help you figure out if supplements are really necessary, or whether they're just more work for you.

Re: Pumped for a baby in NICU, nursing, and oversupply

I actually haven't had to supplement-when I nursed him in NICU he was satisfied until his next scheduled feeding and we just got him home today-so far he's stuck to wanting to eat every two and a half to four hours. Trust me, I've been down the supplement rabbit hole-did it with DD3 and having to nurse, pump and bottle feed eventually led to me exclusively pumping, so I'm very glad that, knock on wood, it appears I won't have to do that again!

Re: Pumped for a baby in NICU, nursing, and oversupply

So far he seems to have settled into a three hour schedule, give or take a bit-they had him on a strict three hour schedule, then moved him to a three to four hour ad-lib schedule yesterday before they discharged him. I'm fine with nursing him on demand, but he honestly seems content every two and a half to three hours.

Re: Pumped for a baby in NICU, nursing, and oversupply

Just wanted to say congratulations on bringing your son home! I had 35 week twin boys this summer and was so happy to bring them home after 13 days in NICU. I don't have enough milk, though, so I can't really help you with the too much milk issue but I wish you the best on getting him settled in at home and fully on breast.

Re: Pumped for a baby in NICU, nursing, and oversupply

Originally Posted by @llli*golightly1118

they had him on a strict three hour schedule, then moved him to a three to four hour ad-lib schedule yesterday before they discharged him.

That strikes me as just weird. You'd think a NICU would want to encourage more frequent feedings than every 3 or 3-4 hours, especially for late preterm babies who aren't so weak and fragile. I mean, most newborns feed around 10-12 times per day, and I'd think that would be a goal to strive for.

Anyway, what matters at this point is that you're happy and baby's happy with a demand-based feeding pattern. I do think you might want to aim for the 10-12 feedings per day for a while to come, though, especially if your baby is giving you more 3 hour intervals between nursing sessions than 2 hour intervals. Some early babies are too sleepy to eat as much as they should, in which case mom needs to encourage a little more feeding than the baby would ask for.

Re: Pumped for a baby in NICU, nursing, and oversupply

That's what I think too regarding feeding him more. Plus, he stuck to a three hour schedule during the day yesterday and wanted to eat every two hours last night-if possible I'd like to gently persuade him to flip that! He's actually pretty alert-tomorrow his gestational age will be 38 weeks, so he's acting more like a full term baby at this point anyway and having alert periods after he eats, as opposed to just falling right back asleep.